One of the more prolific accounts identified in Wikipedia’s subsequent investigation is IP address 109.231.203.194, and its list of edits makes interesting reading. The person or people behind this account were particularly busy with the Wikipedia entry on Melanoma (a type of cancer that most commonly appears on the skin). Their first edit, on September 2nd this year, was to add the following text:

Online screening

A recent telemedicine solution has been developed that allows people to screen moles online in under 24 hours – reducing the burden of needless anxiety on those with benign lesions, and unnecessary consultations with healthcare professionals. The service was launched in September 2010[1] by a company called Moletest and uses a unique ‘computational vision’ to assess photographic images of lesions (melanocytic nevus) against known case results – providing a ‘traffic light’ based evaluation where green is a ‘normal’ lesion, amber a ‘borderline’ lesion with potentially unpredictable biological behaviour, and red a potentially ‘cancerous’ one. The process is overseen by a panel of professional dermatolagists and has the potential to revolutionalise melanoma screening and detection, in the same way that smear testing did for cervical cancer in women.

It turns out that the company Moletest is or was a client of “De Facto Communications”, which describes itself as “Part of Bell Pottinger Health – the healthcare and pharmaceutical arm of the UK’s No.1 PR group” .

But in this case they went one step further – actually removing a whole tranche of text that gave details of how people concerned about a possible skin cancer might check themselves for symptoms. Here’s what they cut:

A basic reference chart used for consumers to spot suspicious moles is found in the mnemonic A-B-C-D, used by institutions such as the American Academy of Dermatology and the National Cancer Institute. The letters stand for Asymmetry, Border, Color, and Diameter.[5][16] Sometimes, the letter E (for Elevation or Evolving) is added. According to the American Academy of Dermatology, if a mole starts changing in size, color, shape or, especially, if the border of a mole develops ragged edges or becomes larger than a pencileraser, it would be an appropriate time to consult with a physician. Other warning signs include a mole, even if smaller than a pencil eraser, that is different than the others and begins to crust over, bleed, itch, or becomes inflamed. The changes may indicate developing melanomas. The matter can become clinically complicated because mole removal depends on which types of cancer, if any, come into suspicion.

A recent and novel method of melanoma detection is the “Ugly Duckling Sign”[17][18] It is simple, easy to teach, and highly effective in detecting melanoma. Simply, correlation of common characteristics of a person’s skin lesion is made. Lesions which greatly deviate from the common characteristics are labeled as an “Ugly Duckling”, and further professional exam is required. The “Little Red Riding Hood” sign,[18] suggests that individuals with fair skin and light colored hair might have difficult-to-diagnose melanomas. Extra care and caution should be rendered when examining such individuals as they might have multiple melanomas and severely dysplastic nevi. A dermatoscope must be used to detect “ugly ducklings”, as many melanomas in these individuals resemble non-melanomas or are considered to be “wolves in sheep clothing”.[19] These fair skinned individuals often have lightly pigmented or amelanotic melanomas which will not present easy-to-observe color changes and variation in colors. The borders of these amelanotic melanomas are often indistinct, making visual identification without a dermatoscope very difficult.

People with a personal or family history of skin cancer or of dysplastic nevus syndrome (multiple atypical moles) should see a dermatologist at least once a year to be sure they are not developing melanoma.

But it nonetheless seem striking that anyone would think it was a good idea to delete a fairly detailed account of how people might check for potential skin cancer symptoms and replace it with a puffy advertorial for a company that charges for online screening.